Self-Reported Items That Predict the Risk of Oral Health Deterioration and the Need for Dental Referral in Older People: A Systematic Review

Abstract

Background: Detecting deterioration in frail oral community-dwelling older people's oral health may be delayed as a consequence of decreased visits to oral health care professionals. Older people are becoming increasingly dependent on medical care and visit other healthcare professionals, highlighting the importance of interprofessional collaboration. There is a need for an easy-to-use, time- and cost-efficient oral health assessment tool for non-oral healthcare professionals. This systematic review aimed to identify self-reported items that predict the risk of oral health deterioration in older people to inform such a tool. Method: The OVID/Medline, Embase, EBSCO/CINAHL, and Web of Science databases were systematically searched. An additional reference check was performed to ensure that no records were missing. The primary outcome was predictive value, defined as the probability of a specific question or self-reported item predicting the risk of oral health deterioration or the need for dental referral. When available, the data were presented as sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: The initial search resulted in 2471 records. Eleven articles met the inclusion criteria and were analysed. A high predictive value for oral health deterioration was observed for the self-reported items: “Are you generally pleased with your mouth and teeth?” (specificity: 93.0%), “Would you say your mouth health is generally good?” (specificity: 95.2%), “Does your mouth feel dry?” (specificity: 82.7%), and “Do you have regular dental checkups?” (sensitivity: 90.0%–100%); and “Do you have tooth and/or mouth problems that make it hard to eat?” (specificity: 92.0). Conclusion: A screening tool for use by non-oral health professionals, that consists of 2–4 highly predictive self-reported items, such as dry mouth, satisfaction with oral health, recent dental visits and food consumption problems, could be used for early detection and timely referral of older people at risk of oral health deterioration.